Case Volume Affects Mortality for Immunosuppressed With Sepsis
FRIDAY, June 8, 2018 -- At hospitals with the lowest volume of immunosuppressed patients with sepsis, the risk of death from sepsis due to a suppressed immune state is highest, according to a study published online June 1 in the Annals of the American Thoracic Society.
Jared A. Greenberg, M.D., from the Rush University Medical Center in Chicago, and colleagues characterized patients with sepsis at hospitals according to immune state. Variation in the odds of in-hospital death from sepsis due to a suppressed immune state was examined based on the average volume of immunosuppressed patients with sepsis each year.
The researchers identified 350,183 patients with sepsis at 60 hospitals from 2010 to 2012. Compared with non-immunosuppressed patients with sepsis, immunosuppressed patients with sepsis at the 15 hospitals in the first quartile had increased odds of in-hospital death (adjusted odds ratio, 1.38). For patients at hospitals in the second, third, and fourth quartiles, the odds of in-hospital death for immunosuppressed patients with sepsis relative to non-immunosuppressed patients with sepsis was similar. The adjusted odds of death from sepsis due to a suppressed immune state (odds ratio, 1.21) was significantly lower for these 45 hospitals analyzed as a group relative to that for the patients at the 15 hospitals in the first quartile (P = 0.004 for difference).
"The risk of death from sepsis due to a suppressed immune state was greatest at hospitals with the lowest volume of immunosuppressed patients with sepsis," the authors write.
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Posted: June 2018